Provider Demographics
NPI:1043897275
Name:EPHRAIM, ADERONKE ROSEMARY (LCSW)
Entity type:Individual
Prefix:
First Name:ADERONKE
Middle Name:ROSEMARY
Last Name:EPHRAIM
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:ADERONKE
Other - Middle Name:ROSEMARY
Other - Last Name:ADENEKAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:127 ALAMERE DR SW
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32908-3453
Mailing Address - Country:US
Mailing Address - Phone:763-647-0923
Mailing Address - Fax:
Practice Address - Street 1:7901 4TH ST N STE 300
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-4399
Practice Address - Country:US
Practice Address - Phone:407-603-9159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-25
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
FLSW171301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical